Patient Forms

Please text, fax, or email completed forms after you fill them out, using a workable phone or computer app if you are able. You may also print the forms.

If you cannot do any of the above, please arrive 25 minutes early to the appointment. If the forms link doesn’t work, send us your email for easy-fillable forms to be sent to you via email.

You will be able to complete this form online.   Be sure you have Acrobat Reader installed on your computer.

> NEW PATIENT CONSENT AND HEALTH HISTORY FORMS <

FAX, TEXT or EMAIL these forms to the office.

Fax: 207-433-1050

Text: 207-307-0816

Email: formfunctionosteopathic@gmail.com

Please click on the link below to read the Notice of Privacy Practices form

Notice of Privacy Practices Form

Credit Card Auth Form

To get to the office:

Follow the sidewalk outside to the side of the building facing Harlow street.

Do NOT go in the lobby.